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Rasmussen University Exam 1: Essentials of
Pathophysiology Exam 1 Review (Latest 2023/2024)
What is Pathophysiology - CORRECT ANSWER--is the study of what happens when the normal anatomy and physiology go wrong, causing disorder and disease process of the human body. What 4 things does pathophysiology include? - CORRECT ANSWER--Etiology, Pathogenesis, Clinical Manifestations, and Treatment Implications What is etiology - CORRECT ANSWER--study of causes or reasons for phenomena. Includes Idiopathic conditions that have an unknown origin or cause. What is pathogenesis? - CORRECT ANSWER--development or evolution of disease from initial stimulus to the expression of manifestations as time occurs. What are clinical manifestations? - CORRECT ANSWER--Signs and symptoms of disorder. What are treatment implications? - CORRECT ANSWER--Which combine the etology, pathogenesis, and clinical manifestations to determine the best treatment of condition per individual. What are signs? - CORRECT ANSWER--Objective or observed manifestations of disease. What are symptoms? - CORRECT ANSWER--Subjective feelings of abnormality in the body. What is objective data - CORRECT ANSWER--What you observe and can measure. What are examples of objective data? - CORRECT ANSWER--rash, low blood pressure, bleeding What is subjective data? - CORRECT ANSWER--What the patient may report to you What are examples of subjective data? - CORRECT ANSWER--pain scale, they feel suicidal, fatigued. What is epidemiology? - CORRECT ANSWER--study of the patterns of disease involving populations. Based on the spread and contact of diseases in people. What are the levels of disease prevention? - CORRECT ANSWER--Primary, Secondary, Tertiary Explain Primary Prevention - CORRECT ANSWER--"Preventing"; altering susceptibility or reducing exposure of disease for people.
Examples of Primary Prevention - CORRECT ANSWER--Vaccinations and Handwashing Explain Secondary Prevention - CORRECT ANSWER--"Screening"; early detection, screening, and management of disease to catch disease early before it spreads Examples of Secondary Prevention - CORRECT ANSWER--PAP smears for STDs, lab work for HBA1C check, mammogram Explain Tertiary Prevention - CORRECT ANSWER--"Treating" and preventing further complications from a disorder or disease after the person has the condition Examples of Tertiary Prevention - CORRECT ANSWER--Rehab for hip surgery, relearning ADL's after amputation, Wound care after stroke to prevent pressure ulcers. What is homeostasis? - CORRECT ANSWER--a state of equilibrium in which all body systems are in balance and the body is at its most optimal in functioning. Stable. What is allostasis? - CORRECT ANSWER--ability to successfully adapt to challenges. It is not a balance but an attempt to adapt to achieve homeostasis. Example: sweating to lower ones body temp. Stages of the General Adaptation Syndrome - CORRECT ANSWER--alarm, resistance, exhaustion Explain alarm stage of general adaptation syndrome - CORRECT ANSWER--Where the sympathetic nervous system is activated due to stress. Fight or Flight responses are activated and energy is given off by the HPA axis to flee or fight the danger ahead. Blood must be redirected to vital organs in this stage to give the organs energy to work. Explain Resistance stage of general adaptation syndrome - CORRECT ANSWER-- the activity of the Parasympathetic Nervous system and the endocrine system to return the body to homeostasis. The body should ultimately adapt to the stressor. Explain the exhaustion stage of general adaptation syndrome - CORRECT ANSWER--Occurs when the stressor is not removed or overcome in the body. The body can no longer return to homeostasis after prolonged exposure to stressor. It causes the body to be depleted and damaged that can lead to disease or death. What complications can occur if stressors are not resolved from general adaptation syndrome? - CORRECT ANSWER--disease can occur physically and mentally, such as anxiety, depression, headaches, insomnia, infection, and heart disease. Name the hormones released during alarm stage of general adaptation syndrome - CORRECT ANSWER--Corticotrophin releasing hormone, adrenocorticotrophic hormone, catecholamines( norepinephrine and epinephrine) and cortisol
Role of Golgi body - CORRECT ANSWER--stacked membranes that act as the sorter and packager for proteins from the ER. Helps move things in and out of cell. Where is extracellular fluid found? - CORRECT ANSWER--outside the cell Where is ECF located in the body? - CORRECT ANSWER--found in the plasma, lymph, CSF, eye humors, synovial fluid, and the GI secretions. Where is intracellular fluid located? - CORRECT ANSWER--inside the cell Where is intracellular fluid found in the body? - CORRECT ANSWER--found inside of cells, cytosol. Which electrolytes are found at high concentrations in the ECF? - CORRECT ANSWER--sodium, chloride and sodium bicarb. Which electrolytes are found at high concentrations in the ICF - CORRECT ANSWER--potassium, magnesium and hydrogen phosphate, and low concentration of sodium and chloride. What is passive transport? - CORRECT ANSWER--substances move from a high to low concentration, without energy. Natural What is active transport? - CORRECT ANSWER--substances move against their concentration gradient with the help of ATP. Low to High. What is diffusion? - CORRECT ANSWER--molecules and ions distributing evenly in the environment. Passive transport used. Goes from high to low concentration and higher the concentration, the faster the spread. What is osmosis? - CORRECT ANSWER--allows for fluids to distribute in between the interstitial spaces and intracellular compartments. Water goes low to high. High: high solute concentration to low water concentration Low: low solute concentration to high water concentration Examples of ways fluid enters the body (Intake) - CORRECT ANSWER--Food, Drink, IV access. Examples of ways fluid exits the body (output) - CORRECT ANSWER--Sweat, Urine, stool, water vapor from lungs, wound drainages, NG secretions. What is dehydration? - CORRECT ANSWER--when water output exceeds intake over time. Water from ECF is lost, causing cells to shrink as concentration increases. What are the causes of dehydration? - CORRECT ANSWER--hemorrhage, severe burns, vomiting, diarrhea, sweating, water deprivation, diuretic abuse, DM.
What are the signs and symptoms one may have dehydration? - CORRECT ANSWER--dry mouth, extreme thirst, dry skin, decreased urine output, weight loss, mental confusion, hypovolemic shock. What is hypotonic hydration? - CORRECT ANSWER--Over hydration or water intoxication. When too much water is taken in too fast or the kidneys cannot rid the fluid fast enough (renal failure). Concentration of water in ECF increases, while osmolarity decreases, causing cells to swell. What things can cause hypertonic hydration? - CORRECT ANSWER--Too much fluids through IV, renal failure, drinking too much water too fast. ` (Hyponatremia). What are the signs and symptoms of hypotonic hydration? - CORRECT ANSWER-- leads to Nausea and Vomiting, muscles cramping, cerebral edema (brain cells can swell and burst) , convulsions, coma and death. What is edema? - CORRECT ANSWER--accumulation of fluid in the interstitial space. Leads to tissue swelling. What are the causes of edema? - CORRECT ANSWER--Increase in the forces that move fluid from capillaries to interstitial compartments or decrease in the opposite. What are some of the factors that encourage edema? - CORRECT ANSWER-- Increase in hydrostatic forces in the capillaries that increases the blood volume, increased capillary permeability, CHF, HYPTN, decrease in plasma proteins like albumin (causes liver to hold onto more water- ascites, cirrhosis), blockage of lymph drainage. Lab values for Sodium - CORRECT ANSWER-- 135 - 145 mEq/L Lab values for Potassium - CORRECT ANSWER--3.5-5.0 mEq/L Lab values for Calcium - CORRECT ANSWER--8.5-10.2 mEq/L Lab Values for Magnesium - CORRECT ANSWER--1.8-2.5 mEq/L Lab Values for Phosphate - CORRECT ANSWER--2.5-4.5 mEq/L What is hypernatremia? - CORRECT ANSWER--high sodium Na > 145 What things can cause hypernatremia? - CORRECT ANSWER--dehydration, loss of water form ECF What are the signs and symptoms of hypernatremia? - CORRECT ANSWER-- excess thirst, lethargy, muscle twitching, convulsions. What is hyponatremia? - CORRECT ANSWER--low sodium Na < 135 What things can cause hyponatremia? - CORRECT ANSWER--water retention, loss of Na from vomiting, diarrhea, burns, too much water.
What things can cause hyperphosphatemia? - CORRECT ANSWER--renal failure, hypoparathyroidism, adrenal insufficiency, hypothyroidism, laxatives, What is hypophosphatemia? - CORRECT ANSWER--Low phosphates P< 2. What things can cause hypophosphatemia? - CORRECT ANSWER-- hyperparathyroidism, alkalosis,deficient intake, vitamin D deficiency, alcoholism, low dietary intake. What electrolyte balance do we see with a positive chovstek and trousseaus sign? - CORRECT ANSWER--Hypocalcemia What is a positive trousseaus sign? - CORRECT ANSWER--BP. When pressure is on the arm, the hand will cramp and curl. What is a positive chvostek sign? - CORRECT ANSWER--Tap on the face and the person's eye/cheek twitch. What are electrolyte reservoirs? - CORRECT ANSWER--where electrolytes are found at an abundance, usually in the bones. Which electrolytes are found in the bones? - CORRECT ANSWER--Calcium, phosphate and magnesium What are the cardinal signs and symptoms of inflammation? - CORRECT ANSWER-
- Redness Heat Swelling Pain Loss of function What lab tests can detect inflammation in the body? - CORRECT ANSWER--C Reactive protein and Erythrocyte sedimentation rate What is a C-reactive protein test? - CORRECT ANSWER--increased level can show systemic inflammation. What is the erythrocyte sedimentation rate test? - CORRECT ANSWER--measures the rate at which the red blood cells in a sample settle at the bottom. Increased level shows systemic inflammation. What is the role of histamine and what effect does it have on the body during immune response? - CORRECT ANSWER--increases the permeability of blood capillaries, vasodilation, hives and itchiness. What is the role of bradykinin and what effect does it have on the body during immune response? - CORRECT ANSWER--released from injured cells that stimulates pain receptors and the mast cells to release histamine, prostaglandins and leukotrienes to increase blood flow.
What is the role of leukotrienes and what effect does it have on the body during immune response? - CORRECT ANSWER--stimulate contraction of smooth muscles. Happens in the respiratory tract when the trachea closes up. What is the role of prostaglandins and what effect does it have on the body during immune response? - CORRECT ANSWER--affects smooth muscle and increases mucus secretion. The trachea starts to grow tight with mucus stuck in it. Explain innate immunity - CORRECT ANSWER--you are born with it. It occurs on the initial exposure to an antigen and there are chemical and physical barriers to prevent invasion such as the skin, mucus membranes, enzymes and pH. Fever, inflammation and phagocytosis is included. Specific or nonspecific: innate Immunity - CORRECT ANSWER--nonspecific Explain adaptive immunity - CORRECT ANSWER--slow to develop. More efficient when there is subsequent exposure. Cells will create memory. Recognizer foreign invaders and destroys foreign invaders. More effective defenses. B Cell= humoral immunity and produces antibodies. T cells are cell mediated immunity and involve T helper and cytotoxic T cells to activate cells to fight foreign invaders. Specific or nonspecific: adaptive immunity - CORRECT ANSWER--specific What is antimicrobial resistance and what factors contribute to it in microorganisms?
- CORRECT ANSWER--resistant strains of microorganisms emerge following exposure to antibiotics, making it harder to treat. Caused by excessive use of antibiotics or subtherapeutic dosing. Will need stronger antibiotics to cure. How can we prevent the spread of microorganisms in healthcare? - CORRECT ANSWER--Must always keep a sterile field if working in one, washing hands, wearing PPE when needed. What is passive immunity? - CORRECT ANSWER--he transfer of preformed antibodies against specific antigens from a protected or immunized individual to an unprotected or non immunized person. Provides immediate and short term protection. No memory cells are produced. Which antibodies does passive immunity involve? - CORRECT ANSWER--IgA and IgE What are examples of passive immunity? - CORRECT ANSWER--mom to fetus through placenta or mom to infant through breast milk. Serotherapy. What is active immunity? - CORRECT ANSWER--a protective state owing to the immune system response as a result of active infection or immunization. It has to be activated in the body and the body has to fight it to have long term immunity.
are sensitized to receptors on the t cell. Reexposure causes the memory cells to release destructive cytokines Examples of Type 4 hypersensitivity - CORRECT ANSWER--TB test- 48 hrs later must be read due to delay. Contact dermatitis. What are characteristics of benign tumors? - CORRECT ANSWER--Localized growth that is curable. They more closely resemble the original tissue type, they grow slowly, have little vascularity, rarely necrotic, and usually have similar function to the original cells. Can be fatal depending on the location (brain, heart,etc), usually grows at the original areas of the body. Encapsulated. What are characteristics of malignant tumors? - CORRECT ANSWER--usually cancerous. They ignore growth controlling signals and replicate despite signals from the environment. They can escape signals and can die. they can also display different functions poorly or not at all related to the tissue. Greater degree of differentiation means that it is more aggressive. Can move around with a poor prognosis. They also do not go through programmed apoptosis What is anaplasia? - CORRECT ANSWER--indicated by the variation in cell size, and shape within a tumor, enlarged nucleus, abnormal division, and bizzare looking cells. What is metastasis? - CORRECT ANSWER--processes where cancer cells escape their tissue of origin and initiate new colonies of cancer at other sites. What are the 3 steps of carcinogenesis? - CORRECT ANSWER--Initation, Promotion, progression Explain initiation stage - CORRECT ANSWER--events which result in changes to chromosomes or DNA. Initiators include radiation, UV or carcinogens. Explain promotion stage - CORRECT ANSWER--stage during which mutated cells proliferate. Hormones ensure progression. Explain progression stage - CORRECT ANSWER--the mutated cells start to exhibit malignant behaviors and permanent changes. What are effects of cancer? - CORRECT ANSWER--depends on the location of it and the extent of degree of metastasis. Can be asymptomatic in early stages. Increases in size can contribute to aggression. Can cause lots of PAIN Explain cachexia - CORRECT ANSWER--overall weight loss and generalized weakness due to loss of appetite, increased metabolic rate, nausea and vomiting, Explain anemia - CORRECT ANSWER--deficiency in circulating red blood cells due to bone marrow suppression.
Explain leukopenia - CORRECT ANSWER--deficiency in circulating white blood cells. Make people more prone to infection. Explain thrombocytopenia - CORRECT ANSWER--deficiency in circulating platelets. Cannot clot! Cannot bleed out as not clotting! No shaving or contact sports. What are warts (verrucae) - CORRECT ANSWER--Common benign papillomas caused by DNA papillomaviruses. Skin is thick. What is herpes simplex virus? - CORRECT ANSWER--begins with a burning or tingling sensation followed by vesicles and erythema that crusts before healing Explain what is herpes simplex 1 - CORRECT ANSWER--Cold Sores. Common on the lips, face, mouth. Pain is common and can heal within 10-14 days. in latent form Explain what is herpes simplex 2 - CORRECT ANSWER--responsible for most infections in the genital area. Is there a cure for Herpes Simplex Virus? - CORRECT ANSWER--No. It is life long. What is herpes zoster (shingles)? - CORRECT ANSWER--acute localized inflammatory disease along the dermatomal segment of the skin caused by varicella zoster.Results from reactivation of the latent virus. Eruption of painful vesicles that are unilateral and can cause paresthesia Where on the body is herpes zoster found? - CORRECT ANSWER--dermatome What disease must you have first before getting herpes zoster? - CORRECT ANSWER--Chicken pox Explain what superficial fungal infections are. - CORRECT ANSWER--fungi that grow in warm, moist places. Manifests as circular erythematous rash with itching and burning. Reddish plaques with peripheral scaling and central clearing. Where are superficial fungal infections usually found? - CORRECT ANSWER--Tinea capitis= scalp, tinea corporis= body, tinea pedis= toes/ feet. What causes yeast infections? - CORRECT ANSWER--candida albicans. Where can you find yeast infections? - CORRECT ANSWER--thrush in babies, intertrigo between the folds of skin in bedridden patients, and mucocutaneous candidiasis in immunocompromised patients. What is impetigo? - CORRECT ANSWER--acute, contagious skin disease characterized by vesicles, pustules and yellow honeycomb crusting. What causes impetigo? - CORRECT ANSWER--staph/strep Is impetigo contagious? - CORRECT ANSWER--yes it is highly contagious
What populations are more at risk for having a pressure ulcer? - CORRECT ANSWER--bedridden, elderly, incontience, amputees, those with contractions Name some of the common places pressure ulcers are found. - CORRECT ANSWER--buttock, head, elbows, and heels What are some risk factors that can lead to pressure ulcers? - CORRECT ANSWER-
- poor nutrition, aging, immobility, sensory loss, bowel and bladder incontinence. How does a stage 1 ulcer present? - CORRECT ANSWER--Intact skin with non blanching redness. How does a stage 2 ulcer present? - CORRECT ANSWER--partial thickness skin loss involving the epidermis or dermis or both. How does a stage 3 ulcer present? - CORRECT ANSWER--full thickness tissue loss with visible fat. How does a stage 4 ulcer present? - CORRECT ANSWER--ull thickness tissue loss with exposed bone, muscle or tendon. Nerves are destroyed so client feels numbness in area. How can we prevent pressure ulcers? - CORRECT ANSWER--turning patients every 2 hours who are bedridden. Appropriate nutrition and hydration. float heels off bed, clean linens, doing incontinence care, movement of patients, barrier cream and wound care of places susceptible to ulcers. How does a first degree burn present? - CORRECT ANSWER--affects only the epidermis and causes pain, erythema and edema. Example of first degree burn - CORRECT ANSWER--sunburn How does a second degree burn present? - CORRECT ANSWER--affects the epidermis and dermis and causes pain, erythema and blistering. Example of second degree burn - CORRECT ANSWER--sun burn that blisters How does a third degree burn present? - CORRECT ANSWER--extends into the deeper tissues, and cause white or blackened charred skin that may be numb due to nerve damage or loss from the burn. Example of third degree burn - CORRECT ANSWER--charred blackened wound from a fire What is compartment syndrome - CORRECT ANSWER--dangerous complication of soft tissue injury that results from swelling or injured tissue within a restrictive fascia. Explain the pathophysiology behind compartment syndrome - CORRECT ANSWER-
- Edema causes increased pressure within the compartment. The pressure reduces
capillary flow and the muscles and the nerves are ischemic and if not treated, necrosis can occur, What must one do when compartment syndrome occurs? - CORRECT ANSWER-- reduce pressure so blood flow can occur. usually a fasciotomy is performed so that blood flow can occur What are 5 P's of compartment syndrome? - CORRECT ANSWER--Pain Pallor Paresthesia Paralysis Pulselessness What is osteomyelitis? - CORRECT ANSWER--severe pyogenic infection of bone and local tissues What can cause osteomyelitis? - CORRECT ANSWER--can be caused by burns, sinus disease, trauma, tumors, periodontal infection and pressure ulcers, open fractures, penetration of wounds, surgical contamination or use of metal screws What can occur with osteomyelitis? - CORRECT ANSWER--necrosis What is osteoporosis? - CORRECT ANSWER--common metabolic disease and occurs when the rate of bone resorption is greater than bone formation. The bones end up becoming fragile and light, bone are porous.Can lead to short stature, muscle wasting, back spasms and difficulty bending. Which group of people are most affected by osteoporosis? - CORRECT ANSWER-- women age 60-80 that are caucasian. What is osteoporosis caused by? - CORRECT ANSWER--estrogen deficiency, poor calcium intake and disuse of supplements. How do we diagnose osteoporosis? - CORRECT ANSWER--bone mineral density scan When does rickets occur? - CORRECT ANSWER--children When does osteomalacia occur? - CORRECT ANSWER--adults What is rickets/osteomalacia? - CORRECT ANSWER--softening of the bones due to insufficient calcium and vitamin D. defects in bone building process What is osteosarcoma? - CORRECT ANSWER--bone tumor. Is malignant and grows fast. Can be destructive and pain full (metastatic bone cancer). The lesions can spread from the bone to other organs as well. Commonly found at the pelvis, proximal ends of femur, humorous and ribs. When does one get muscular dystrophy? - CORRECT ANSWER--it is inherited
What is psoriatic arthritis? - CORRECT ANSWER--Caused by genetics, t lymphocytes and macrophages infiltrating skin and joints, producing inflammatory cytokines. Signs and symptoms of psoriatic arthritis - CORRECT ANSWER--oligoarthritis, combined soft tissue and peripheral joint disease What substance is affected with gout? - CORRECT ANSWER--high amounts of uric acid What is gout? - CORRECT ANSWER--disorder in which the disturbance of uric acid metabolism leads to deposition of uric acid crystals in the joints. risk increases with age. Characterized by hyperuricemia, and urate crystal induced arthritis. Recurrent attacks of articular and periarticular inflammation, renal and uric acid calculi.
